To save his family, a Marine fights his war again, from a therapist's chair

By Thomas James Brennan

Stars and Stripes

Published: October 4, 2012

By mid-March, his depression, anger, alcoholism and isolation were affecting his marriage. He had built an emotional barricade and took his anger out on her.

Five months later, sitting alone, Andrew J. Czubai reflected on how he lost what meant the most to him — his family. He realized he saw this coming. It’s not something he wanted, but it’s something that could have been prevented. Many people suggested he get help but he was too stubborn. He thought he could fix himself or cope. He wished he had listened.

"It may be too late to save my family,” he said, “But there is no harm in trying.”

He wants his wife back and he wants his daughter back. At the very least, he wants a piece of his old self back. To get it, he will do what he long resisted. He will sit in a therapist’s chair and go back to war.

***

For Andrew, there is no question how he got here. A family man, he always had high spirits. Easily finding a purpose in everything, he never found it hard to smile.

That man was lost in Afghanistan on Nov. 23, 2010. He was shot in the arm and evacuated to the United States. In the beginning he was surrounded by family. It should have made him happy. It didn’t.

Instead, he felt he had abandoned his brothers overseas and started drinking to numb the emotional pain. Having no decompression time made the transition from combat to daily life difficult.

“I got shot on Tuesday and by Saturday I was holding my daughter,” he said, “Leave wasn’t enjoyable. In fact, it was very confusing.”

After a year of living with his symptoms, his wife of nearly three years, Melissa, asked for a legal separation and that he move out of their home. On Aug. 26, 2012, while emptying his duffel bag at his uncle’s house reality hit him. He reached a new low.

Thoughts of suicide rushed into his head. He felt he had lost everything and debated whether life had a purpose. But he thought of his daughter and then checked himself into a Texas Veterans Affairs hospital where he was immediately evaluated and given follow-up appointments with a mental health professional. It was also the end of his heavy drinking.

***

Having served in the Marine Corps as one of his superiors, I knew Andrew very well. He was jovial and you could always hear him from a mile away. His personality was infectious.

We kept in touch after he was discharged in 2011, but on Sept. 10, 2012 I got a haunting message from him. The first words were, “I’m going through some really dark stuff”.
I knew I had to call him.

He told me he still struggles with what happened in Afghanistan and with life at home, and he told me that he needed therapy.

He describes a situation spanning months where he was too busy fighting his inner demons to notice he was driving his wife away. All of his selfishness is clear now and he replays it repeatedly in his mind. The images serve as both torture and penance.

I shared with him my struggles with post-traumatic stress disorder. I told him therapy was the most demanding thing I had ever done because reliving combat is sometimes more difficult than initially going through it. Then I made sure to tell him that it was also the best thing I had ever done — for myself and family — and that the first session is always the hardest.

On Sept. 20, Andrew began Prolonged Exposure Therapy, which according to the National Registry of Evidence-based Programs and Practices is a cognitive-behavioral treatment program for adults with PTSD.

Prolonged Exposure is the most widely used treatment regimen among veterans and servicemembers. The main element of PE is Imaginal Exposure, which requires the patient to revisit the traumatic experience verbally numerous times. Prolonged Exposure typically lasts eight to 15 sessions.

I spoke with Andrew after his therapy session on that Thursday. He called it the most mentally taxing event of his life, yet at the end he felt a weight had been lifted off his shoulders.

***

In the beginning, he’s perched in his chair, leaning slightly forward and gripping his dog tags. Both eyes are closed, his sweaty palms move to grip the armrests. His legs twitch underneath the chair. The anxiety and tension in his voice are unmistakable.

The therapist guides him slowly as he describes the setting of his trauma. Smells of trash and feces begin to fill the room. The sun-baked mud houses turn real in his mind. He can feel and hear the Velcro on his gear, stretching and straining under its own weight. Smooth steel rests against his right index finger. It’s midnight in November 2010 and he is back on patrol in Afghanistan.

As he begins telling his traumatic event for the first time, Andrew begins to dissociate and succumb to a flashback. He is no longer just retelling the story. He believes he is living it.
But the therapist pulls him back in and the story continues. With it comes chaos and a firefight. Screaming. Confusion. Bloodshed.

He is now moist with sweat. In his mind, the bullet strikes him and he begins to massage his injured arm. He complains of phantom pains.

The therapist stops him. He’s accomplished more than most on his first day of treatment.
The session ends with a deep-breathing exercise and small talk to help calm him down.

He begins to relax in his chair, his legs no longer trembling. His eyes open and after a few moments, he loses the thousand-yard stare and is able to make eye contact with the therapist.

He did excellent, she says, telling him that he made a pivotal step toward recovery.

Since he began therapy for his combat stress, his wife has also agreed to go with him to couples therapy. There are no promises, but there is hope.

“I was so afraid of getting help for so long,” says Andrew, “Now I wish I hadn’t waited so long to get the help I needed.”

Thomas James Brennan is a sergeant in the Marine Corps. He deployed to Iraq and Afghanistan with 1st Battalion, 8th Marines. Now, 27 and still on active duty, he is stationed at Camp Lejeune, N.C. He is a member of The Military Order of the Purple Heart and a graduate of The Veterans Writing Project. Follow him on Twitter at @thomasjbrennan.